Cherokee Nation sues opiod wholesalers, retailers

The Cherokee Nation sued distributors and retailers of opioid medications on Thursday, alleging the companies have contributed to "an epidemic of prescription opioid abuse" within the tribe and have not done enough to prevent tribal members from acquiring illegally prescribed opioid painkillers.

The lawsuit alleges that six distribution and pharmacy companies have created conditions in which "vast amounts of opioids have flowed freely from manufacturers to abusers and drug dealers" within the 14 northeastern Oklahoma counties that comprise the Cherokee Nation.

The tribe argues the companies regularly turn a "blind eye" to opioid prescriptions that would require further investigation before pills are dispensed. The lawsuit also alleges the companies have pursued profits instead of trying to reduce opioid-related addition that has taken the lives of hundreds of Cherokee citizens and cost the tribe hundreds of millions of dollars in health care costs.

Wouldn't you think they'd focus on the doctors prescribing the meds? Our folks have been specifically told to use alternative treatment and only prescribe opioids as a last resort or if absolutely necessary.

I could see the retail pharmacies possibly intervening if they have a person showing up regularly with an opioid prescription or something, but unless there is some high tech way to create your own prescription that I'm not aware of the doctors should play a pretty important role in stopping the "vast amounts of opioids flowing freely" right?

I mean let's face it, there probably aren't many of us on this board who have tried "to reduce opioid-related addition that has taken the lives of hundreds of Cherokee citizens and cost the tribe hundreds of millions of dollars in health care costs.", but they ain't suing any of us.

I mean let's face it, there probably aren't many of us on this board who have tried "to reduce opioid-related addition that has taken the lives of hundreds of Cherokee citizens and cost the tribe hundreds of millions of dollars in health care costs.", but they ain't suing any of us.

They should. Everyone on LT is a multimillionaire (don't be poor) or billionaire.

Wouldn't you think they'd focus on the doctors prescribing the meds? Our folks have been specifically told to use alternative treatment and only prescribe opioids as a last resort or if absolutely necessary.

I could see the retail pharmacies possibly intervening if they have a person showing up regularly with an opioid prescription or something, but unless there is some high tech way to create your own prescription that I'm not aware of the doctors should play a pretty important role in stopping the "vast amounts of opioids flowing freely" right?

Distributors and pharmacies do make a lot of money on the over-prescribing of opiods. I am curious if they have a smoking gun, showing one of these companies acknowledging that fact. Maybe an email or a whistleblower from one of the companies.

Man there are some ignorant, inbred, racist motherfuckers on this board. The funny thing is, I am betting the abuse is coming from predominately white people (meaning their big toe is Cherokee) who aren't really Cherokee at all and are simply taking advantage of the 'handouts' they get from the Cherokee Nation.

The Cherokee Nation is doing quite well and is probably indirectly responsible for many of the jobs you ****s have (those of you that work).

Maybe, just maybe there is something to this? I mean we all know pharmaceutical companies are some of the most righteous out there, right?

Distributors and pharmacies do make a lot of money on the over-prescribing of opiods. I am curious if they have a smoking gun, showing one of these companies acknowledging that fact. Maybe an email or a whistleblower from one of the companies.

Maybe, but why would that matter? Distributors and pharmacies cannot make a single penny on opiods without a doctor authorizing the prescription.

Man there are some ignorant, inbred, racist motherfuckers on this board. The funny thing is, I am betting the abuse is coming from predominately white people (meaning their big toe is Cherokee) who aren't really Cherokee at all and are simply taking advantage of the 'handouts' they get from the Cherokee Nation.

The Cherokee Nation is doing quite well and is probably indirectly responsible for many of the jobs you ****s have (those of you that work).

Maybe, just maybe there is something to this? I mean we all know pharmaceutical companies are some of the most righteous out there, right?

The Cherokee Nation health system isn't providing healthcare to folks who aren't legit tribal members last time I checked . . . so how are white folks benefiting?

Man there are some ignorant, inbred, racist motherfuckers on this board. The funny thing is, I am betting the abuse is coming from predominately white people (meaning their big toe is Cherokee) who aren't really Cherokee at all and are simply taking advantage of the 'handouts' they get from the Cherokee Nation.

The Cherokee Nation is doing quite well and is probably indirectly responsible for many of the jobs you ****s have (those of you that work).

Maybe, just maybe there is something to this? I mean we all know pharmaceutical companies are some of the most righteous out there, right?

Man there are some ignorant, inbred, racist motherfuckers on this board. The funny thing is, I am betting the abuse is coming from predominately white people (meaning their big toe is Cherokee) who aren't really Cherokee at all and are simply taking advantage of the 'handouts' they get from the Cherokee Nation.

The Cherokee Nation is doing quite well and is probably indirectly responsible for many of the jobs you ****s have (those of you that work).

Maybe, just maybe there is something to this? I mean we all know pharmaceutical companies are some of the most righteous out there, right?

My issue with it is that they, like everyone else it seems, want to pass on the blame to someone other than who is really responsible.

I understand it i a huge ordeal for Docs to even prescribe them now. When I had that major surgery last year, I was put on Tramadol after I came out of ICU! TRAMADOL! I had to learn to deal with it and I do not like pain, couldn't even talk the Doc into a Vicodin "because in Ukraine, these drugs for cancer patients only." which is a whole different thread..... BUT, what they don't tell you is this Tramadol you have to take a ton of is more addictive than just your plain ole opiates. I never had a problem with those, yet I had to wean myself off Tramadol. Anyway, I want my pain pills when needed! I guess I have no point other than restrictions will get tougher than they already are.

So you'd consider a pharmacist filling a prescription (following on federal and state guidelines) requested by a licensed physician as potentially indirectly supporting someone's opioid addiction?

Only way I'd even go down that road is if they pharmacy isn't checking refills or the identity of those picking up the prescription . . . or if it's being issued based on an outdated prescription.

The pharmacy isn't deciding who should be prescribed what . . .

Or am I not understanding your point?

I think you are missing my point a little.

My point was that they could be liable if they aren't doing what they are supposed to or somehow incenting the doctors to write more prescriptions. That second part would be more likely to occur with a distributor than a pharmacy.

If the pharmacy and distributors aren't doing anything wrong, of course they shouldn't be liable.

No one here knows the facts of the case. It is like the McDonald's case. Most people just assume that it was a frivolous case, until they actual learn the facts of the case.

My point was that they could be liable if they aren't doing what they are supposed to or somehow incenting the doctors to write more prescriptions. That second part would be more likely to occur with a distributor than a pharmacy.

If the pharmacy and distributors aren't doing anything wrong, of course they shouldn't be liable.

No one here knows the facts of the case. It is like the McDonald's case. Most people just assume that it was a frivolous case, until they actual learn the facts of the case.

My point was that they could be liable if they aren't doing what they are supposed to or somehow incenting the doctors to write more prescriptions. That second part would be more likely to occur with a distributor than a pharmacy.

If the pharmacy and distributors aren't doing anything wrong, of course they shouldn't be liable.

No one here knows the facts of the case. It is like the McDonald's case. Most people just assume that it was a frivolous case, until they actual learn the facts of the case.

More liable than a doctor prescribing highly addictive medication without a legit medical reason?

And everyone who picks up medication is provided with information on side effects and has the opportunity to meet with a pharmacist . . . just like anyone ordering coffee shouldn't be shocked it is hot.

More liable than a doctor prescribing highly addictive medication without a legit medical reason?

And everyone who picks up medication is provided with information on side effects and has the opportunity to meet with a pharmacist . . . just like anyone ordering coffee shouldn't be shocked it is hot.

There is no way that the pharmacy or the manufacturer induced the doctor to write the prescriptions. If there is any issue here, it is with the doctor who has his name on the script. I doubt that very many of the prescriptions were obtained without the doctor's intentional authorization. I am a pain doctor. I spend a lot of (most?) of my time poking, prodding, encouraging patients to take less medication. I have encountered several on very high doses who I can't find anything wrong with and I don't know why their original dr was prescribing. If they are receptive, I gently wean them down. If they aren't they move on to try to convince someone else to rx at precious dosages. Many patients have come to me with no diagnosis. Just years of treatment with opioids. Patients with a terrible knee that have never seen an orthopedist, back pain but no MRI, etc

I don't need to watch that video to know that McDonald's heated their coffee way hotter than they needed to . . . but good grief, don't put it between your freaking legs and then be shocked it spills and burns. Now nobody should suffer 2nd maybe 3rd degree burns from coffee, but again . . . don't go putting it between your legs.

So you think the pharmacists and pharmacy suppliers more to blame than the physicians?

For real?

Relative power is extremely important in determining culpability. We don't know the facts of how the manufacturers and distributors have behaved, so we don't know what their level of culpability is. But there are absolutely plausible scenarios where they shoulder a large part of the blame.

Concur. They duped the people down the supply chain to think the dependency rate was less than other pain pills. The supply chain prescribed and prescribed thinking that and all it did was create dependency and demand for more.

I don't need to watch that video to know that McDonald's heated their coffee way hotter than they needed to . . . but good grief, don't put it between your freaking legs and then be shocked it spills and burns. Now nobody should suffer 2nd maybe 3rd degree burns from coffee, but again . . . don't go putting it between your legs.

If you don't want to watch the video watch the documentary about it in Netflix. Honestly amazes me that there are still people out there that have bought into the false narrative of the frivolous lawsuits epidemic. The facts and numbers still don't support this "epidemic".

If you don't want to watch the video watch the documentary about it in Netflix. Honestly amazes me that there are still people out there that have bought into the false narrative of the frivolous lawsuits epidemic. The facts and numbers still don't support this "epidemic".

Yep. And I am a corporate attorney, I'm not a litigator and have no skin in this game.

What happened to personal responsibility? Should doctors overprescribe? Of course not. But maybe the people popping all the pills should, ya know, stop......Another reason MJ should be allowed to be prescribed in OK....

Sometimes a patient will pull the "why did my dr do this to me?" line. I remind them that they were the one taking and asking for more medication when they had to have known they were already taking a lot of medication. Usually, the pt just tries to move the conversation along. It absolutely is a two way street but the ultimate responsibility is with the dr. The reasons a dr would continue to overprescribe: 1. Ignorance 2. Weakness (afraid of making pt mad) 3. Lack of business overall. 4. He is deep into opioid prescribing and is making a ton of money off of his in office urine confirmatory tests. 5. He has an opioid problem or sexual relationship with the patient.

1-3 are very common with pcp's. 4 is the "pain specialist" who has no formal training in pain, doesn't do any procedures, and never makes any referrals for alternative treatment. He has the patients on high doses and keeps higher risk patients in order to justify more testing. 5 could be anybody and is usually what brings the dr to the attention of the medical board.

PA's and NP's thankfully can not rx schedule 2 opioids. This helps limit the community supply and gives them the easiest way to say no. I do think it would be reasonable for them to be able to rx 20 pills one time, if say they have an ankle fracture hobble into their clinic. They tend to be more guilty of prescribing cough syrup way to frequently and overprescribing xanax.

What happened to personal responsibility? Should doctors overprescribe? Of course not. But maybe the people popping all the pills should, ya know, stop......Another reason MJ should be allowed to be prescribed in OK....

Sometimes a patient will pull the "why did my dr do this to me?" line. I remind them that they were the one taking and asking for more medication when they had to have known they were already taking a lot of medication. Usually, the pt just tries to move the conversation along. It absolutely is a two way street but the ultimate responsibility is with the dr. The reasons a dr would continue to overprescribe: 1. Ignorance 2. Weakness (afraid of making pt mad) 3. Lack of business overall. 4. He is deep into opioid prescribing and is making a ton of money off of his in office urine confirmatory tests. 5. He has an opioid problem or sexual relationship with the patient.

1-3 are very common with pcp's. 4 is the "pain specialist" who has no formal training in pain, doesn't do any procedures, and never makes any referrals for alternative treatment. He has the patients on high doses and keeps higher risk patients in order to justify more testing. 5 could be anybody and is usually what brings the dr to the attention of the medical board.

PA's and NP's thankfully can not rx schedule 2 opioids. This helps limit the community supply and gives them the easiest way to say no. I do think it would be reasonable for them to be able to rx 20 pills one time, if say they have an ankle fracture hobble into their clinic. They tend to be more guilty of prescribing cough syrup way to frequently and overprescribing xanax.

There is also a problem with patients handing off their unused pain meds to other people....

What happened to personal responsibility? Should doctors overprescribe? Of course not. But maybe the people popping all the pills should, ya know, stop......Another reason MJ should be allowed to be prescribed in OK....

Lol. You realize this stuff is highly physically and mentally addicting.

Relative power is extremely important in determining culpability. We don't know the facts of how the manufacturers and distributors have behaved, so we don't know what their level of culpability is. But there are absolutely plausible scenarios where they shoulder a large part of the blame.

Okay . . . what are some of those plausible scenarios?

Free crap for docs who prescribe x amount of opioids? Would something like that have to be indicated in their lawsuit in order for it to go to court in the first place?

If you don't want to watch the video watch the documentary about it in Netflix. Honestly amazes me that there are still people out there that have bought into the false narrative of the frivolous lawsuits epidemic. The facts and numbers still don't support this "epidemic".

Okay . . . so our system isn't being clogged with frivolous lawsuits in any way?

Okay . . . so our system isn't being clogged with frivolous lawsuits in any way?

No, it's not. The courts do a very good job of dismissing frivolous lawsuits, and in fact they kick out a lot that should probably be able to move forward.

As for plausible scenarios, incentivizing overprescription through any number of ways, and withholding information about the dangerousness of the drugs (a la tobacco companies) are the two that jump to mind.

Okay . . . so our system isn't being clogged with frivolous lawsuits in any way?

It is, but not in the technical sense (that's a term of art in litigation). From a layman's point of view, many of the lawsuits filed these days would be considered frivolous, but that term has a unique meaning within the context of litigation.